Gastric Cancer Diagnostic Market By Modality (Endoscopy, Histopathology, Tumor Marker Tests, Molecular Diagnostics, Liquid Biopsy); By Application (Screening & Early Detection, Diagnostic Confirmation, Therapy Guidance, Recurrence Monitoring); By End User (Tertiary Hospitals, Diagnostic Labs, Community Hospitals, Ambulatory Endoscopy Centers); By Geography, Segment Revenue Estimation, Forecast, 2024–2030

Introduction And Strategic Context

The Global Gastric Cancer Diagnostic Market is projected to expand at a CAGR of 6.8% , reaching approximately USD 5.7 billion by 2030 , up from an estimated USD 3.8 billion in 2024 , according to Strategic Market Research.

 

This market sits at the intersection of oncology, precision medicine, and diagnostic imaging. At its core, gastric cancer diagnostics involve tools and technologies used to detect, stage, and monitor stomach cancer — a disease that remains among the top five causes of cancer-related mortality worldwide. Unlike some fast-moving diagnostics spaces, this market is defined by both urgency and complexity. Gastric cancer is often diagnosed late due to vague early symptoms, so early-stage detection capabilities are increasingly being treated as life-saving assets rather than just clinical enhancements.

 

Between now and 2030, the landscape for gastric cancer diagnostics is shifting due to three major forces: early screening mandates, non-invasive liquid biopsy innovation, and rising gastric cancer incidence across aging populations. In high-burden countries like Japan, South Korea, and China — where gastric cancer rates are significantly higher — governments are expanding screening access and reimbursement for advanced diagnostics. Meanwhile, in Western markets, there’s growing focus on molecular profiling and histopathology to tailor therapies to tumor subtypes, especially in HER2-positive or MSI-high gastric cancers.

 

On the tech front, diagnostic platforms are moving beyond traditional endoscopy and biopsy. We're seeing the emergence of AI-assisted image interpretation, genetic mutation panels, and tumor marker assays — all aimed at reducing false negatives and catching malignancies earlier. Several oncology centers are also piloting breath-based diagnostic technologies and circulating tumor DNA ( ctDNA ) tests as part of multi-modal screening strategies.

 

From a stakeholder perspective, this market is becoming crowded with innovation-driven players. OEMs, molecular diagnostic firms, pharma-companion diagnostic alliances, hospitals, and government health systems are all part of a dynamic ecosystem. Investment funds are also entering the space, lured by a diagnostic category where demand is steadily climbing and competitive differentiation is increasingly data-driven.

 

To be honest, gastric cancer diagnostics used to be viewed as a small offshoot of gastrointestinal testing. But not anymore. With immunotherapy, targeted drugs, and biomarker-driven treatment protocols reshaping gastric oncology, the diagnostic arm is no longer optional — it's foundational.

 

Market Segmentation And Forecast Scope

The gastric cancer diagnostic market cuts across multiple axes, reflecting both traditional screening modalities and a new wave of molecular and biomarker-based tools. This market isn’t just defined by how gastric cancer is detected — but when, where, and in whom. Below is how the market typically segments in terms of modality, application, end-user base, and region.

By Diagnostic Modality

This remains the most technically diverse segment. Here's a breakdown of how modalities stack up:

• Endoscopic Imaging
  Still the frontline tool for diagnosing gastric cancer, particularly in high-risk regions like Japan and Korea where routine upper endoscopy is government-mandated. Narrow-band imaging (NBI) and endoscopic ultrasound (EUS) are being used more frequently to enhance detection of early lesions.

• Biopsy and Histopathology
  The gold standard for confirmation. However, delays and inter-observer variability remain challenges in non-specialist settings.

• Tumor Marker Tests
  Blood-based diagnostics measuring markers like CEA, CA 19-9, or CA 72-4 are increasingly used to complement imaging — but they tend to lack sensitivity in early-stage cases.

• Molecular and Genetic Testing
  Includes HER2 testing, PD-L1 expression, microsatellite instability (MSI), and next- gen sequencing (NGS) panels. These are critical for patients eligible for targeted or immune therapies and are becoming standard in advanced-stage diagnoses.

• Liquid Biopsy and ctDNA Assays
  A fast-growing sub-segment that may disrupt conventional approaches. These tests offer a non-invasive route to monitor recurrence, treatment response, or residual disease. Liquid biopsy accounted for roughly 9–11% of the diagnostic revenue in 2024 and is expected to double in share by 2030.

 

By Application

The core applications fall under:

• Screening and Early Detection
  Vital in countries with population-wide screening programs. Tools like AI-assisted endoscopy and serum pepsinogen tests are gaining traction.

• Diagnostic Confirmation
  Covers the initial diagnosis pathway using imaging + biopsy. This still represents the largest revenue-generating application in 2024.

• Therapy Guidance and Prognostics
  This segment is expanding as precision medicine becomes the norm. Molecular testing and HER2/MSI status are key revenue drivers here.

• Monitoring and Recurrence Surveillance
  ctDNA , PET-CT imaging, and novel assays are being used to track patient status after surgery or chemotherapy — a growing priority in long-term patient management.

 

By End User

Demand patterns shift based on care complexity and access:

• Hospitals and Cancer Specialty Centers
  These dominate the market, handling complex biopsies, staging, and molecular profiling. Most high-volume gastric cancer diagnoses happen here.

• Diagnostic Laboratories
  Increasingly handling molecular tests and liquid biopsies in centralized facilities.

• Ambulatory Endoscopy Centers
  Rising in number, especially in countries with aging populations and decentralized care models. These centers focus on quick, minimally invasive diagnostics.

• Academic and Research Institutions
  While not major commercial end-users, they drive innovation — especially in AI imaging models and biomarker research.

 

By Region

• Asia Pacific is the largest and most mature regional segment, led by Japan, South Korea, and China, where gastric cancer screening is part of public health strategy.

• North America is gaining traction in molecular diagnostics and HER2 testing, though incidence rates are lower.

• Europe shows moderate but stable demand, with countries like Germany and Italy leading in advanced imaging adoption.

• LAMEA remains underpenetrated but is drawing investment for endoscopy expansion and public-private diagnostic collaborations.

Scope Note: The line between diagnostics and treatment planning is blurring. Many diagnostic systems now bundle image-guided biopsy with predictive molecular panels, pushing vendors to offer integrated solutions instead of standalone tests.

 

Market Trends And Innovation Landscape

Innovation in the gastric cancer diagnostic market is being shaped by a growing need for speed, precision, and patient-specific insight. Unlike other oncology segments that are laser-focused on therapy, this market is seeing diagnostics take center stage — as early detection, real-time monitoring, and therapy alignment become deal-breakers in patient outcomes.

AI-Powered Endoscopy Is Gaining Real-World Use

AI isn’t just a buzzword anymore — it’s now integrated into clinical workflows. In Japan and parts of Europe, deep learning algorithms are helping endoscopists spot subtle mucosal changes that signal early gastric lesions. These tools not only increase sensitivity but reduce diagnostic fatigue — especially in high-volume screening settings.

One gastroenterologist in Seoul mentioned that with AI support, they’ve seen a 22% increase in detection rates for early gastric cancer during routine screenings — without adding any additional procedure time.

These systems are increasingly being bundled into high-definition endoscopy platforms, suggesting that the next competitive edge may lie in embedded software, not just hardware.

 

Liquid Biopsy Is Crossing Into Clinical Routine

Initially seen as futuristic, liquid biopsy is becoming part of real-world care. ctDNA assays for gastric cancer are being used to detect minimal residual disease (MRD) post-surgery and to monitor relapse — especially in patients treated with adjuvant therapies. While still less commonly used than tissue-based methods, platforms like Guardant360 and FoundationACT are expanding trial coverage into gastric tumors .

The promise? A completely non-invasive way to track tumor dynamics in real time — especially important in a cancer known for high recurrence and rapid progression.

 

Molecular Diagnostics Are Driving Companion Therapy Uptake

With HER2-positive and MSI-high tumors responding better to targeted and immune therapies, diagnostic labs are scaling up NGS panels , IHC testing , and in situ hybridization services. HER2 testing has shifted from being “optional” to “required” in most advanced cases, and MSI testing is increasingly used as a marker for checkpoint inhibitor eligibility.

This isn’t just a clinical trend — it’s a reimbursement shift. Payers in the U.S., Germany, and Japan are now mandating biomarker testing before approving high-cost oncology treatments. That’s pulling molecular diagnostics further into the frontline of care.

 

Multi-Modal Diagnostic Platforms Are Emerging

Instead of selling a single tool, some vendors are moving toward diagnostic ecosystems — combining endoscopy, pathology integration, AI software, and biomarker panels in one workflow. These “diagnostic suites” are appealing to high-volume cancer centers and large hospital chains in Asia and Europe.

Think of it this way: rather than buying five separate tools, hospitals get one integrated solution with imaging, biopsy support, and molecular profiling — reducing downtime and diagnostic delay.

 

New Frontiers: Exhaled Breath and Microbiome Testing

Still in early R&D, but showing potential:

• Breathomics platforms are testing volatile organic compounds (VOCs) in exhaled breath to detect gastric cancer signatures. Trials in Israel and China show promise.

• Microbiome-based diagnostics are being explored to understand how gastric bacteria (including H. pylori) may affect cancer development or treatment response. The use of microbial biomarkers could be the next phase in early-risk prediction.

The bottom line: innovation here isn’t just about finding cancer — it’s about finding it early, matching it to the right therapy, and tracking it without invasive procedures. This shift is turning diagnostics from a one-time test into a continuous care tool — and that’s opening the door for startups , AI vendors, and lab networks that were never part of traditional oncology care.

 

Competitive Intelligence And Benchmarking

The gastric cancer diagnostic market features a unique blend of legacy imaging companies, molecular diagnostic firms, and fast-moving digital health startups — all competing across different parts of the diagnostic journey. Unlike other diagnostic fields where one modality dominates, here the winners are those who can operate across imaging, pathology, and molecular layers.

Olympus Corporation A dominant player in endoscopic imaging , Olympus continues to lead in high-definition and narrow-band endoscopy systems used in early gastric cancer screening, particularly in Japan, South Korea, and parts of Europe. Their integration of AI-enhanced detection algorithms into new platforms is helping them maintain relevance as the market shifts toward smart diagnostics. Their strength isn’t just technology — it’s deep institutional penetration in countries with mandated screening programs.

 

Roche Diagnostics A powerhouse in molecular and immunohistochemistry (IHC) testing , Roche offers HER2, MSI, and PD-L1 diagnostic kits that are tightly integrated into gastric cancer therapy workflows. As checkpoint inhibitors and HER2-targeted drugs gain ground in gastric oncology, Roche’s companion diagnostic footprint becomes more valuable. Their cobas platform is widely adopted in centralized labs, and recent digital pathology acquisitions are pushing them further upstream.

 

Guardant Health A key player in liquid biopsy , Guardant is one of the few companies actively expanding ctDNA testing into gastric cancer indications. While their initial focus was lung and colon cancer, they’ve begun working with clinical centers in East Asia on feasibility studies for post-surgical monitoring in gastric cancer. Their edge lies in early-mover status in non-invasive MRD (minimal residual disease) detection, which is where many experts believe the future of recurrence surveillance lies.

 

Thermo Fisher Scientific With its NGS platforms and multiplexed assay development tools, Thermo Fisher is positioned well in molecular diagnostics . The company provides research-use and clinical-use panels for HER2 amplification, KRAS mutations, and MSI profiling. Their kits are often used in reference labs and research hospitals across Europe and Asia. While not a front-line vendor, they’re the tech backbone behind many lab-developed gastric cancer assays.

 

Boston Scientific A niche but growing force in endoscopic biopsy tools , Boston Scientific is targeting the procedural side of gastric diagnostics — with innovations in forceps, needle guidance systems, and retrieval devices. These tools improve biopsy accuracy during endoscopy, especially in deeper or difficult-to-access lesions. Their strategy is more about enhancing procedural efficiency than owning the diagnostic result, but it still creates critical value in the chain.

 

Fujifilm Holdings In addition to their imaging footprint, Fujifilm is branching into AI-assisted endoscopy and is investing in real-time video analytics for gastric lesion identification. Their dual-focus approach — hardware plus AI — is helping them gain market share in South Korea and Taiwan, where national screening programs are looking for faster throughput with high detection accuracy.

 

Competitive Dynamics Summary

• Olympus and Fujifilm are the go-to brands for smart endoscopy systems in Asia — where routine screening dominates.

• Roche and Thermo Fisher control the molecular end — powering therapy selection and reimbursement workflows.

• Guardant Health is setting the pace for non-invasive monitoring — a space that could eat into traditional biopsy revenue.

• Boston Scientific adds precision at the procedural level — optimizing the sample collection that underpins downstream testing.

To be honest, this market doesn’t have a single leader. It has multiple power centers . Diagnostic control now depends on who owns the most real estate across the diagnostic pathway — from initial detection to therapy guidance. The companies that can connect imaging, pathology, and molecular testing into a single workflow will shape the next chapter of gastric cancer care.

 

Regional Landscape And Adoption Outlook

The gastric cancer diagnostic market looks radically different depending on where you are. While the disease burden is global, diagnostic approaches, funding models, and infrastructure vary widely across regions. Some countries prioritize mass screening. Others lean heavily on biomarker-guided treatment selection. These differences are defining not just market share — but where the next wave of diagnostic innovation lands.

Asia Pacific — The Demand Core

This is by far the largest and most mature regional market, thanks to sheer volume and proactive public health policy. Countries like Japan , South Korea , and increasingly China have institutionalized endoscopic screening for gastric cancer , especially in adults over 40. These programs are government-funded and run through both hospital systems and dedicated screening centers .

Japan, for example, has one of the highest gastric cancer detection rates in the world — not because of disease prevalence alone, but due to aggressive early screening. High-definition endoscopy with AI support is already being adopted across university hospitals and regional clinics.

China is scaling fast. With rising incidence and increasing coverage through national health reforms, the country is investing in low-cost, high-throughput diagnostic centers . Local players and startups are developing cost-effective imaging and biomarker tools tailored for rural use — an under-addressed segment with significant upside.

South Korea is also investing in AI-powered endoscopy and HER2 diagnostic protocols, linking screening to personalized therapy strategies.

 

North America — Precision Over Volume

The U.S. and Canada show lower gastric cancer incidence but higher emphasis on precision diagnostics , especially at advanced stages. Rather than broad screening, the focus is on molecular testing — HER2, PD-L1, MSI, and more — to align treatment plans with immunotherapies and targeted drugs.

Academic centers and cancer networks like MD Anderson and Memorial Sloan Kettering are pushing adoption of NGS panels , liquid biopsies , and ctDNA monitoring . Coverage by payers is improving, especially when testing directly informs treatment eligibility.

However, a key challenge is under-screening in high-risk subpopulations — particularly immigrants from East Asia or Latin America. Some community health systems are piloting culturally tailored outreach programs to close this diagnostic gap.

 

Europe — Standardized but Fragmented

Europe follows a middle path. Countries like Germany , France , and Italy have high adoption of advanced diagnostics — particularly IHC testing and endoscopic ultrasound — but strategies vary by country.

In Germany , statutory insurers cover HER2 and MSI testing for gastric cancer. France is investing in AI-based imaging pilots. Southern and Eastern Europe , however, still lag in infrastructure. In some regions, endoscopy wait times and access to molecular labs slow down timely diagnosis and therapy matching.

The European Society for Medical Oncology (ESMO) is pushing for greater harmonization of gastric cancer diagnostic standards, but adoption is uneven.

 

Latin America, Middle East & Africa (LAMEA) — Underserved but Opening Up

This region has high potential but remains underdiagnosed and underfunded. In Brazil and Mexico , urban cancer centers are starting to adopt HER2 testing and biopsy-driven diagnostics , but rural access is limited. Public-private hospital partnerships are growing, especially in areas with international NGO involvement.

In the Middle East , countries like Saudi Arabia and the UAE are investing in oncology-focused hospitals that offer endoscopic and molecular diagnostics, often as part of broader health system modernization. But these are exceptions rather than the norm.

Africa continues to be the most underserved. Gastric cancer is often diagnosed late, and most diagnostics rely on generic GI testing. Portable endoscopy units and mobile biopsy labs are being piloted by non-profits, but scale remains a barrier.

 

Regional Summary

• Asia Pacific : High-volume screening and early-stage detection. Most AI and endoscopic innovation is being deployed here first.

• North America : Precision diagnostics dominate. Liquid biopsy and therapy-aligned testing are the main growth drivers.

• Europe : Strong in imaging and molecular protocols, but fragmented adoption across countries.

• LAMEA : Nascent market with growing interest in modular, affordable diagnostics — especially in urban hubs.

The regional dynamic is clear: volume lives in Asia , value lives in the West , and white space lives in LAMEA . Success in this market will depend not just on selling diagnostic tools — but on aligning them with what each region actually needs and can support.

 

End-User Dynamics And Use Case

Gastric cancer diagnostics aren’t just about technology — they’re about timing, access, and trust. Different end users play very different roles in this market, and understanding their diagnostic behavior is key to designing scalable solutions. Whether it’s a tertiary hospital or a small diagnostic lab, each end-user type brings its own set of expectations — and bottlenecks.

Tertiary Hospitals and Cancer Centers

These are the heavyweights of the gastric cancer diagnostic market. They perform the full stack: from endoscopy and biopsy to histopathology , HER2/MSI testing , and increasingly, liquid biopsy for monitoring recurrence.

Most therapy-aligned diagnostics — such as NGS panels or IHC scoring — happen in these centers because they have both the lab capacity and the clinical demand. Many are linked to academic research hubs and participate in clinical trials , giving them early access to next-gen diagnostics. They also serve as reference centers for smaller hospitals in surrounding regions.

For vendors, this is where bundled solutions work best — imaging, software, and lab integration all in one package.

 

Community Hospitals

These hospitals often rely on external labs for advanced molecular testing. They perform initial endoscopy and biopsy but send samples out for confirmatory or genomic profiling. Time delays in this process can affect treatment planning.

To compensate, some are adopting cloud-based digital pathology to speed up review or outsourcing interpretation to centralized AI-enabled reading centers . Vendors that offer modular upgrades — like AI-assisted endoscopy plug-ins or biopsy enhancement tools — are seeing traction here.

 

Diagnostic Labs

Molecular and pathology labs are gaining ground, especially in HER2 testing and ctDNA workflows . These labs often serve regional hospital networks or oncology practices and handle everything from sample processing to interpretation and reporting .

Their pain points include turnaround times , sample logistics , and data integration with hospital EHRs. Vendors offering LIS-compatible diagnostic platforms with therapy-linked reporting dashboards are in a good position here.

 

Ambulatory Endoscopy Clinics

These centers , particularly in Asia, handle high-volume gastric screening — often as part of national public health programs. The focus is on speed and accuracy , not full-on molecular diagnostics.

Operators want compact endoscopy systems , AI overlays for lesion detection , and high-throughput biopsy tools . These clinics usually refer complex cases to larger hospitals but serve a critical gatekeeping function in early detection.

In Japan and South Korea, these clinics are a huge source of repeat business for Olympus, Fujifilm, and AI software vendors alike.

 

Use Case Highlight

A regional cancer center in Chennai, India, began piloting a hybrid diagnostic workflow to cut down diagnostic delays. Previously, gastric cancer patients underwent endoscopy locally, but molecular profiling had to be sent to labs in metro cities — causing a 12– 15 day lag.

To solve this, the center implemented a semi-automated HER2 IHC kit paired with cloud-based pathology review using AI-assisted scoring software. Results were now available within 72 hours — fast enough to initiate targeted therapy without waiting weeks.

Within six months, they reduced therapy initiation delays by 45% and improved adherence to guideline-based care. Local oncologists reported higher confidence in test quality, and patient drop-offs between diagnosis and treatment declined.

Bottom line: whether it's high-end cancer centers or decentralized screening clinics, every end-user type is looking for faster, more actionable diagnostics . The tools that succeed aren’t always the most complex — they’re the ones that fit into real-world workflows without adding friction.

 

Recent Developments + Opportunities & Restraints

Recent Developments (Last 2 Years)

• Olympus Corporation introduced a next-gen AI-enabled endoscopy platform in Japan (2024), capable of real-time detection of early-stage gastric lesions using deep learning algorithms.

• Guardant Health launched a gastric cancer-specific ctDNA assay pilot across select centers in South Korea and Taiwan in early 2024, targeting recurrence monitoring post-surgery.

• Roche Diagnostics received expanded regulatory approval in Europe (2023) for its HER2 IHC companion diagnostic for gastric and gastroesophageal junction (GEJ) cancers, supporting a broader range of immunotherapy decisions.

• Fujifilm partnered with a leading Korean cancer institute in 2023 to co-develop cloud-based AI-assisted pathology software , improving turnaround times for gastric biopsy scoring in rural hospitals.

• Thermo Fisher Scientific announced the inclusion of gastric cancer markers in its Oncomine NGS panel in mid-2023, enabling simultaneous detection of HER2, MSI, and other actionable mutations from FFPE samples.

 

Opportunities

• Molecular Stratification Is Now a Standard
  Increasing adoption of HER2, MSI, and PD-L1 testing in clinical workflows is driving demand for integrated diagnostic platforms that connect pathology with treatment decision-making.

• Emerging Markets Are Ramping Up Screening Capacity
  Countries like India, Vietnam, and Indonesia are investing in portable endoscopy units and centralized pathology labs , opening up new mid-tier buyer segments.

• AI-Enabled Endoscopy Is Creating New Product Categories
  Deep-learning-powered lesion detection is no longer experimental — it’s becoming part of bundled value propositions offered by imaging vendors, especially in Asia.

 

Restraints

• Low Early Detection Rates in Western Markets
  Due to non-specific symptoms and lack of screening protocols, gastric cancer often goes undetected until advanced stages in the U.S. and parts of Europe — reducing the impact of early diagnostic tools.

• Capital Cost and Workflow Complexity
  Advanced diagnostics like liquid biopsy and NGS require significant investment in lab infrastructure, skilled personnel, and sample logistics — making adoption difficult in smaller hospitals.

 

7.1. Report Coverage Table

Report Attribute	Details
Forecast Period	2024 – 2030
Market Size Value in 2024	USD 3.8 Billion
Revenue Forecast in 2030	USD 5.7 Billion
Overall Growth Rate	CAGR of 6.8% (2024 – 2030)
Base Year for Estimation	2024
Historical Data	2019 – 2023
Unit	USD Million, CAGR (2024 – 2030)
Segmentation	By Modality, Application, End User, Geography
By Modality	Endoscopy, Histopathology, Tumor Marker Tests, Molecular Diagnostics, Liquid Biopsy
By Application	Screening & Early Detection, Diagnostic Confirmation, Therapy Guidance, Recurrence Monitoring
By End User	Tertiary Hospitals, Diagnostic Labs, Community Hospitals, Ambulatory Endoscopy Centers
By Region	North America, Europe, Asia-Pacific, Latin America, Middle East & Africa
Country Scope	U.S., China, Japan, South Korea, Germany, India, Brazil, etc.
Market Drivers	- Rising demand for early-stage gastric cancer detection - Growing integration of molecular diagnostics with therapy workflows - Innovation in AI-powered endoscopy and non-invasive testing
Customization Option	Available upon request